Gallstones (also called gallstones) cholelithiasis) are hard, gravel-like deposits that can form in the gallbladder, the pear-shaped digestive organ below the liver. These deposits are made up of minerals such as cholesterol and bilirubin that are collected in bile, a digestive fluid produced by the liver and stored in the gallbladder.
Studies estimate that up to 15% of Americans will develop gallstones at some point in their lives. However, people assigned female at birth have a slightly higher risk. Gallstones vary greatly in size. Some are as small as a grain of rice, while others are the size of a golf ball. Most gallstones do not cause symptoms, but symptoms may occur if the stone is large or if the stone becomes lodged in the bile duct.
Gallstones can form for a number of reasons. This can often be caused by internal imbalances, such as excess cholesterol, bilirubin (a by-product of red blood cell destruction), or bile in the gallbladder. However, various health conditions and lifestyle habits can also increase the risk of gallstone formation.
Bile is a yellow-green liquid produced by the liver and stored in the gallbladder. Bile carries waste products and excess cholesterol from the liver to the gallbladder and releases them into the small intestine. This process aids digestion and helps the body absorb vitamins and digest fat.
Normally, salts in bile can break down cholesterol that is excreted (or excreted) by the liver. Too much cholesterol can cause the buildup to harden and form crystals. Over time, these crystals can turn into stones and sometimes get stuck in the bile ducts, causing symptoms. Cholesterol gallstones are the most common type, accounting for approximately 80-90% of all gallstone cases.
The body regularly “recycles” blood cells, breaking down old cells and making new ones. Bilirubin is a yellow pigment left over from the breakdown of old red blood cells (RBCs). Like cholesterol, bilirubin is a substance that travels from the liver to the gallbladder through bile.
However, certain health conditions can cause the liver to produce too much bilirubin, which can cause pigment stones to form in the gallbladder. These types of stones are darker in color and typically appear brown or red. Chromoliths are even rarer and cause only 3% of all gallstone cases. You may be at higher risk of developing pigmented stones if you have an underlying blood disorder, such as anemia.
If the gallbladder does not empty normally, bile can build up inside. High concentrations of bile can lead to crystal precipitation and contribute to gallstone formation. Too much bile in your system can cause both cholesterol and pigmented stone types.
Typically, dysfunction within the gallbladder and other underlying health problems can cause bile excess. These include injuries, infections, neurological disorders and intestinal disorders.
Evidence suggests that genetics may play a role in the development of gallstones. Researchers identified 20 genes associated with gallstones, including ABCG5/ABCG8 and CYP7A1. Many of these genes can be passed from parents to children, which is why having a family history of gallstones is a risk factor for cholelithiasis.
The specific genes carried affect the function of the liver and pancreas, increasing the risk of gallbladder-related problems and blockages. Researchers found that about 36% of all gallstone cases run in families. Of this population, 50.9% had parents and 35.1% had siblings with a history of gallstones.
Several underlying health conditions and lifestyle factors can increase your risk of developing gallstones. These factors often affect the gallbladder's ability to break down bilirubin, cholesterol, or both, which can lead to the formation of stones.
hormonal fluctuations
For people assigned female at birth, high levels of the hormone estrogen may increase the risk of gallstones. Therefore, pregnancy, hormone replacement therapy (drugs that use estrogens or estrogen derivatives), and certain types of birth control are all risk factors for gallstones.
obesity
Obesity can seriously affect liver and gallbladder function. Impaired liver and gallbladder function can make it difficult for the body to properly process bile and increase the risk of gallstone formation.
rapid weight loss
On the other hand, rapid weight loss may increase your risk. In particular, bariatric (weight loss) surgery, such as gastric bypass surgery, can affect organ function too quickly. Researchers found that 10 to 38 percent of people who undergo weight loss surgery eventually develop gallstones.
liver and bile duct infections
Severe liver scarring (medically equivalent) cirrhosis) can often be caused by hepatitis infections and excessive drinking. Injury to the liver and its tissues can affect liver function and cause chemical imbalances in the bile.
Likewise, bile duct infections (medically speaking) Cholangitis) may also affect the bile. The bile ducts are tubes that carry bile in and out of the liver. If this tube becomes infected or inflamed, you may be at a higher risk of developing gallstones.
anemia
Anemia is a type of blood disorder in which red blood cells are destroyed prematurely. Sickle cell anemia (an inherited anemia that causes red blood cells to have irregular shapes) is often associated with gallstones. In one study of people with sickle cell anemia, approximately 25.2% of participants developed gallstones.
diabetes mellitus
Diabetes can increase blood sugar levels by making it difficult for the body to break down and digest glucose (sugar). This condition occurs when the pancreas does not produce enough insulin or the body does not use insulin properly. Researchers found that having diabetes may increase the risk of developing gallstones by 46%.
cholesterol problems
Because gallstones are often caused by excess cholesterol, having high blood cholesterol levels can also increase your risk of gallstones. There are two main types of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is often known as “good” cholesterol and LDL is often known as “bad” cholesterol. Having too much LDL in your blood increases your chances of developing gallstones.
metabolic syndrome
Metabolic syndrome is a combination term for several health problems that can occur when you have three of the following:
- Hyperglycemia (elevated blood sugar levels)
- High blood pressure (high blood pressure)
- obesity
- Increased triglyceride levels (a type of fat)
- low HDL cholesterol
In an extensive study of 12,050 people with metabolic syndrome, researchers found that people with the condition were 1.75 times more likely to develop gallstones than people without metabolic syndrome.
intestinal disease
Your intestines help you absorb nutrients and vitamins from the food you eat. Certain inflammatory bowel diseases, such as Crohn's disease, can affect this function and overall digestion. Because bile is important for digestion, disruptions in the way the body processes food can alter the chemical balance of the gallbladder, increasing the risk of gallstones.
lifestyle habits
Along with underlying health conditions, your lifestyle habits can also affect your likelihood of developing gallstones. These include:
Gallstones are small, gravel-like deposits that form in the gallbladder, a small organ beneath the liver. Gallstones often have no symptoms, but if gallstones become lodged in the bile duct, they can cause symptoms.
A chemical imbalance in the bile is the main cause of gallstones. Underlying health conditions, such as liver and bile duct infections, obesity, and hormonal changes, may increase your risk of developing gallstones.